Cavernous sinus thrombosis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
  • The symptoms of (disease name) typically develop ___ years after exposure to ___.
  • If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common symptoms of cavernous sinus thrombosis include:
    • Severe holocranial and bifrontal headache whit increasing severity
    • Swelling, redness, or irritation around one or both eyes
    • Drooping eyelids
    • Inability to move the eye
    • High fever
    • Pain or numbness around the face or eyes
    • Fatigue
    • Vision loss or double vision
    • Seizures
    • Altered mental status that can range from confusion to coma

Complications

  • Common complications of cavernous sinus thrombosis include:
    • [Complication 1]
    • [Complication 2]
    • [Complication 3]

Prognosis

References

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Natural History

In reality, most patients with cavernous sinus thrombosis do not present with such serious illness, and if they survive tend to have a better prognosis than patients with arterial thrombosis. The real trick is suspecting and making the diagnosis.

Complications

Progressive coma and death with hemorrhagic infarction pathologically.

Prognosis

  • Prognosis better as diagnosis is increasing made with imaging instead of autopsy, with mortality rates down from 100% to 6.5% in a recent review of 76 patients.
  • Poor prognostic features:
    • Rapid progression
    • Coma
    • Extremes of age
    • Focal signs and symptoms
    • Hemorrhagic infarct
    • Serious underlying cause
  • Of note, if patient survives, outcome is better than for arterial infarct

References


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